[Roentgenologic diagnosis and differential diagnosis of carcinomatous lymphangiosis of the lungs]

Abstract

Generalised lymphatic carcinosis, also known as lymphangitis carcinomatosa, cannot be diagnosed by just one x-ray film of the thoracic organs. However, if an enhanced reticular striated pattern is seen, possibly associated with miliar stippling or hilar masses it is recommended to perform short-term follow-ups and comparisons with previous x-ray films. Lymphangitis carcinomatosa becomes probable if rapid progression of the findings or development of new lesions is seen besides the already existing ones and if this is associated with rapidly increasing dyspnoea. Pulmonary tomography will not yield highly significant results, but it can substantiate the diagnosis, the same applies to computed tomography of the thorax. CT is particularly important in differential diagnosis. Earliest possible diagnosis of lymphangitis carcinomatosa is of great importance for therapy, since it may be a first pointer towards an unknown metastasising primary tumor or haematogenous dissemination of already known tumours.